Personality Disorders Raise Substance Abuse Risk

Article excerpt

LOS ANGELES -- A nationwide study has begun to shed light on the complex relationship between personality disorders, and substance use onset and dependence.

The odds of alcohol dependence, drug abuse/dependence, and nicotine dependence were elevated for people with any personality disorder in the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a longitudinal study of more than 43,000 Americans, said Deborah S. Hasin, Ph.D., professor of clinical public health at Columbia University, New York.

Dr. Hasin unveiled results of a selective analysis of substance use prevalence and persistence data from NESARC Waves 1 (2001-2002) and 2 (2004-2005) during a symposium at the annual meeting of the American Academy of Addiction Psychiatrists.

For example, she found that having any personality disorder based on DSM-IV diagnostic criteria increased the odds of meeting criteria for alcohol dependence more than sevenfold at an initial interview during Wave 1 of the study.

The highest baseline rates of alcohol dependence were among individuals with schizotypal personality disorder, dependent personality disorder, or borderline personality disorder, Dr. Hasin said at the annual meeting of the American Academy of Addiction Psychiatrists.

The odds of drug abuse or dependence were elevated more than 13-fold for people with any personality disorder, 13.2, with the highest odds for current use seen among people with schizotypal (odds ratio, 13.2) or borderline personality disorders (see chart).

Nicotine dependence was nine times higher in people with personality disorders as other respondents, with the highest odds found in those with schizotypal and borderline personality disorder.

The study design also allowed the researchers to track persistence of dependence. People with schizotypal, borderline, or antisocial personality disorders who initially were identified as dependent on alcohol were at least twice as likely as others in the study to be persistently dependent 3 years later, even after adjusting for demographic factors and comorbid Axis I diagnoses. …